The A-fib Rhythm Conundrum

Of the various known heart rhythm disorders, atrial fibrillation is one of the most common types. The New York Times just reviewed this condition in great detail. The biggest risk from untreated A-fib is stroke. However, one thing it didn’t mention was the strong association between A-fib and obstructive sleep apnea (OSA). OSA is also known to independently raise your risk of stroke.

Studies have found very high rates of OSA in patients with A-fib. One study reported that 81.6% of A-fib patients had obstructive sleep apnea. It works the other way as well: Having OSA quadruples your risk of having A-fib. One year after cardioversion for A-fib, the rate of recurrence in patients with untreated OSA was almost double those without OSA (82% vs. 42%).

Given the high rate of OSA in patients with A-fib, it’s puzzling why cardiologists don’t routinely screen for OSA. 

If you were ever diagnosed with A-fib, were you also screened for obstructive sleep apnea?

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4 thoughts on “The A-fib Rhythm Conundrum

  1. I was hospitalized with A-Fib two years ago. I am only now being diagnosed with sleep apnea, and no doctor has mentioned the correlation. I am just now trying to gather facts and information to determine how I should be treated. After a miserable night in the hospital, I realize that a cpap is not something I can tolerate, but it seems that there isn’t much of an alternative.

  2. My sister has hypertension and a-fib. She had her annual cardiologist appt. last week to receive medication and I asked her to ask him about sleep apnea. My sister has a very large neck (maybe about 18.5″), small recessed chin, crooked teeth, deep fatty bags under her eyes, overweight, postmenopausal, tired—these are the obvious physical correlations to apnea.

    The dr. said that there are a lot of things associated with a-fib and immediately dismissed her question. I asked her if he asked her if she snored or if she volunteered that info. and she said “no.” Her family says she snores loudly.

    In my opinion, she and her dr. both choose to ignore the obvious. Whatever…

    On a very positive note, last Friday, Dr. Oz talked about postmenopausal women are at the same risk as men for sleep apnea and he also said women with over a 16.5″ neck are at high risk for apnea.

    Another positive note: I met a woman last Sunday who said her mother developed Alzheimer’s in her 60s and she said her mother had obvious severe sleep apnea issues. She said she thinks her mother had Alzheimers because of the sleep apnea. I told her that was a very smart assumption.

  3. My 83 year old mother had her first AFIB about three years ago. She fortunately was able to convert back with meds in the hospital. Her cardiologist immediately scheduled a sleep study and sure enough, she has severe sleep apnea. She has done very well following her protocol and has had only one mild relapse. But, that was following my father’s passing, after a year at home with hospice care due to his end stage dementia and her not taking her Meds correctly. With everything going on, I think she has done well. I know a major part of that is because her OSA is treated. I compare this to her brother who has been hospitalized several times now and they can’t get his ryth hm to normalize. He refuses to have a sleep study and “wear one of those things.” I am thankful my mothers doctors are up to speed on OSA and AFIB and that she has been receptive to its treatment. CPAP is so much easier that a medication routine. Really! She will forget her meds, but always puts on her “breathing machine” at night. Funny.

  4. Holly,

    Thanks for sharing your story. It’s encouraging that cardiologists are getting better at looking for OSA in patients with A-fib. Good luck with your mother.